A Fitting Tribute to Epilepsia Partialis Continua

Publication date: Available online 18 August 2015 Source:Annals of Medicine and Surgery Author(s): Priyank Patel, Nirav Amin, Shreya B. Patel, Catrin Morgan In July 2014, a 66 year-old lady presented to emergency department after having not been seen for 3 days. She was eventually found in bed not responding verbally. The ambulance service reported tonic-clonic seizures lasting 10-30 seconds every 3 minutes. The patient was treated for her seizures with phenytoin and additional benzodiazepines as required. Her seizure had temporarily resolved and she was admitted for investigations. She had no history of epilepsy or seizures. The history of alcoholism and lack of any substantial history of epilepsy, left the team considering whether this was an alcohol induced event or a pseudoseizure. The patient referred to no prodrome, no tongue biting/incontinence and lacked any convincing post-ictal phases. The seizures were no longer tonic-clonic but evolved into focal motor, with right-sided facial twitching lasting 2 minutes. Her investigations from bloods, lumbar puncture, computerised tomography scan and magnetic resonance imaging were all normal which led the team to consider whether this was a pseudoseizure. The patient appeared unconscious during seizures but was rousable during the episodes, although she claimed to have no recollection of them after. The seizures frequency settled at 30/day after being resistant to most antiepileptic regimes, except the eventual comb...
Source: Annals of Medicine and Surgery - Category: Journals (General) Source Type: research